Advances in Dental Research, Vol 7, 120-126, Copyright © 1993 by International & American Associations for Dental Research
Diagnosis of intracapsular pathology associated with temporomandibular joint disorders
K. Murakami and G. T. Clark
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kyoto University, Japan.
The clinical diagnosis of a Temporomandibular Disorder (TMD) has
traditionally been based on data gathered by means of a medical history and
physical examination. The most common signs and symptoms associated with
TMD are reduced jaw opening, pain and elevated tenderness in the muscles of
mastication, pain and elevated temporomandibular joint (TMJ) tenderness,
and TMJ noises upon movement. These signs and symptoms are routinely
detectable by a skilled clinician upon examination. Unfortunately, the
clinical problem described globally as a TMD has several different and
overlapping patho-physiologic disease processes, and a traditional clinical
examination does not provide highly tissue-specific pathologic information.
Were it readily available, such information would be greatly useful, since
logical and accurate treatment planning requires that each disease process
be correctly identified. One important challenge for researchers interested
in TMD will be the careful definition and subsequent validation of
diagnostic methods which identify the relevant ongoing pathological disease
process. On such research area, which has great promise, is the
establishment of a valid diagnostic technique for intracapsular pathologies
unique to TMD patients. This paper provides a critical review and
discussion of the diagnostic validity of TMJ arthroscopy and other related
methods of identifying intracapsular pathologies associated with TMD.
